Do you know that wound dehiscence after abdominal surgery is associated with mortality rates of 10−44%? Surgical wound dehiscence is a postoperative complication involving the breakdown of a surgical incision site.
Surgical wound dehiscence is a postoperative complication involving the breakdown of a surgical incision site. Despite the increased knowledge of wound healing mechanisms before and after surgery, wound dehiscence may increase the length of hospital stay, patient inconvenience, and the rates of re-operation.
Do you know that wound dehiscence after abdominal surgery is associated with mortality rates of 10−44%?
Risk Factors for Wound Dehiscence:
Patients older than 65 years are more likely to develop wound dehiscence because of deterioration in tissue repair mechanism compared with younger patients.
- Hypoproteinemia
- local wound infection
- anemia
- hypertension
- emergency surgery
- abdominal distension
- excessive coughing
- vomiting
- constipation
- nutrition status
- operative time exceeding 2.5 hours
- suture material, drain
- medical history such as obesity with body mass index (BMI) greater than 30
- stroke
- chronic obstructive pulmonary disease (COPD), pneumonia
- malignancy
Pre-operative risk factors:
- poor laboratory findings
- infection
- hypertension
- emergency surgery
Wound infection is the most relevant factor, and it increases the possibility of wound dehiscence by decreasing tensile strength and fibroblast concentration. Decreased fibroblast concentration triggers tissue destruction during wound healing.
Hypoproteinemia also reduces tensile strength. It is required to reduce the incidence of wound dehiscence through preoperative control of these areas.
Postoperative risk factors include:
- abdominal distension
- excessive coughing
- vomiting
- constipation
- resolving these symptoms with appropriate medication may reduce the likelihood of wound dehiscence
Treatment of Dehisced Surgical Wounds
A normal, healing surgical incision should be treated according to post-operative instructions, maintaining good hygiene, and using an appropriate dressing. Avoid unnecessary strain on the wound site. For a dehisced wound, a patient should return for wound care immediately. This may include debridement, antibiotic therapy, and advanced wound healing products like cultured skin grafts or use of another type of wound closure device like wound vac. Following this treatment, the wound will need to be monitored extremely closely for signs of recurring dehiscence.
At Vayu Advanced Wound Clinic, with Dr. Badam’s expertise in post-surgical wound care, she does a comprehensive exam, customizing wound care based on individual patient’s needs with a goal of “Quick wound healing”
For a consultation with Dr. Badam, call or text 210-651-1112.